Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01079840A | IN |
N | 111NI0900X | Internist | 01079840A | IN |
N | 207R00000X | Internist | BP10034936 | TX |
N | 111NI0900X | Internist | BP10034936 | TX |
N | 207RR0500X | Rheumatology | 01079840A | IN |
Y | 207RR0500X | Rheumatology | MD467962 | PA |
NPI | 1063641017 |
---|---|
Provider Name | Dr. Shraddha Jatwani |
First Address | Philadelphia, PA 19141-3030 |
Second Address | Philadelphia, PA 19141-3044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2009 |
Last Update Date | 09/11/2020 |